COVID Variants of Concern

People wait to receive a COVID-19 vaccination at a sport complex in Cascais, Portugal.   Credit: Rodrigo Cabrita/Anadolu Agency/Getty

"[Viruses may not have a brain], but they're governed by the same evolutionary drive that all organisms are -- their first order of business is to perpetuate themselves."

Paulo Verardi, virologist, vaccinologist, University of Connecticut

 

"They [vaccines] work, and we have to get them out. If variants continue to evolve, that's when we're going to run into problems [particularly with the South African and Brazilian variants]."

"We need to reach out to the hesitant, showing them safety data. If you get infected with the virus you have a much higher probability of being critically ill than any probability of a vaccine side effect."

"With deforestation and climate change, humans and wild animals are coming in closer contact and these zoonotic exchanges are being seen more and more frequently."

"[While it's not known how long vaccine-induced immunity will last, one shot you don't fall sick, with two shots you don't make anyone else sick."

"Once a large proportion [of the population] gets both vaccines, we will see the numbers drop."

Virologist Marc-Andre Langlois, Coronavirus Variants Rapid Response Network

"The science has been saying for some time that the VOCs [variants of concern] are more dangerous, but health policies are tending to follow rather than lead."

"That shared mutations have arisen independently from across the world suggests that the virus is showing convergent evolution. In other words, there are only so many moves that the virus is capable of making regarding altering its spike protein and still be infectious, replicate and then go on to infect additional people."

"[But evolution has its limits] Sooner or later the virus is predicted to run out of options regarding mutating its spike proteins; the route of infection into human cells."

"At some point in time, one of these infected people is going to generate a new [variant of concern] that sufficiently avoids the current vaccine-driven immune response, and when that person gets on a cruise ship or plane [the new variant could spark its own pandemic]."

Dr.Terrance Snutch, chair, Canadian COVID-19 Viral Genomics Network

An intensive care unit in London. People with COVID-19 swamped London hospitals in early 2021 as a deadly viral variant spread across the United Kingdom.Credit: Victoria Jones/PA/Alamy

Younger people, according to doctors' reports, are arriving in ICUs desperately in need of ventilation or artificial lung support. "It's hard to tell if the variants will cause more permanent lung damage", observed Dr.Marcelo Cypel at University Health Network in Toronto. "I don't think we can say that yet", he added, in view of a "new pandemic" overwhelming parts of the country. That pandemic is attributable largely to the presence of three variants; the B.1.1.7, first seen in Britain, the Brazilian variant (P.1) and the South African B.1.351.

Hospitals in Ontario, British Columbia and Alberta, struggling to cope with a new influx of COVID patients have declared their own states of emergency, halting all non-urgent surgery. Looming on the near horizon is the potential to launch a critical triage protocol whereby should the variants bring with them crisis levels, random selection determinations of which patient will ultimately receive the vacant ICU bed can be initiated when no other options are available. Unknown as yet is how much of a threat the variants pose, and what kind of mutation could arrive at some near future date. Above all, will the vaccines prevail?

In laboratory experiments, one SARS-CoV-2 variant partially evaded the immune response to the Pfizer-BioNTech vaccine.   Credit: Juan Barreto/AFP/Getty

The evolutionary trajectories of the variants are being tracked by experts across Canada; their role, to advise governments at various levels. The greater the numbers in the population infected awaiting inoculation against the SARS-CoV-2 virus, the more opportunity for the virus to evolve and transform itself into a more threatening pathogen. To the present, the vaccines used across the country have proven effective against the influx of variants, preventing hospitalization and death. And as virologists point out reducing the pool of those infected means the virus has less opportunity to replicate and generate variants.

Variants are fast spreading in the country. Officially in the first week of January, 22 were reported. That number swelled to 25,000 to the present, and growing. Younger and previously healthy adults are now experiencing severe and critical sickness in the presence of the variants. What remains unclear is whether the variants bear a higher biological affinity for younger bodies. A study out of Brazil links the P.1 variant to sudden and dramatic spikes in COVID-19 deaths in younger adults. "All groups above 20 years of age showed statistically significant increases in CFR (case fatality ratio, representing the proportion of deaths among confirmed cases) when diagnosed in February 2021 as opposed to January 2021", the researchers reported.

 

Currently, the reigning variant in Canada is B.1.1.7 from the U.K., accounting for 90 percent of variants infecting Canadians; slightly more deadly and "there's a reasonable possibility it could even get worse", commented University of Oxford professor of evolution and genomics Aris Katzourakis. New York City, California, Paris, London have seen the emergence of variants as well. Herd immunity is the goal but the long-term effectiveness of the first generation of vaccines is unknown, while the virus will continue circulating in the non-vaccinated throughout the world.

 

While India banned international flights last month, Canada is one of 13 nations exempted via an 'air bridge' arrangement between the two governments. Photo by Jack Boland /Postmedia Files

And now, other news is emerging from India. Out of its huge population and its struggle to gain a level of control, one of the world's largest vaccine-producing countries is vaccinating as efficiently as it can in the face of production problems and vaccine supply uncertainties. And the emergence of its own variants. "Such mutations confer immune escape and increased infectivity", according to a March 24 statement from India’s Health Ministry. “These mutations have been found in about 15-20% of samples and do not match any previously catalogued VOCs."

Oh, and between March 21 and April 6, 121 flights landed in Toronto carrying infected passengers  — 42 of those flights arrived from Delhi. Yet another infiltration into Canada of yet another more infectious, more problematically lethal variant, with no 'educated guesses' on when it might all conceivably come to a hopeful, abrupt end, when entire populations have been effectively immunized; even so, most experts believe the COVID-19 virus will become seasonal, requiring an annual vaccine recalibrated each time to reflect virus variants.

This  troubling new ‘double-mutant’ strain, which earned designation B.1.617, is believed responsible for surges of COVID-19 infections in India’s hardest-hit states, according to health officials.

A health-care worker tends to a person with COVID-19 in London, where the viral variant B.1.1.7 caused cases to surge.    Credit: Kirsty Wigglesworth/AFP/Getty